| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,047.13 | $1,047.13 | $1,047.13 | |
Cigna
| Facility | $954.99 | $4,365.16 | $4,786.30 | |
Medcost
| Facility | $1,047.13 | $1,174.90 | $2,290.87 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |